CMS Price Transparency Data

X-ray, pelvis

Facility: Dupont Hospital LLC

Billing Code: 72170 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72170
  • Insurance Median: $169
  • Cash Discount Price: $130
  • vs. Medicare Baseline: 1.58x Medicare
The contracted insurance negotiated median rate for a X-ray, pelvis at Dupont Hospital LLC is $169. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $130. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.58x the Medicare baseline. Located in 2520 E Dupont Rd, Fort Wayne, IN.
Cash / Self-Pay
$130

Average discount available for prompt cash payment at this facility.

Insurance Median
$169

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$106.81

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $106.81 (100%)
Cash / Self-Pay: $130 (122%)
Insurance Median: $169 (158%)
Cash: $130 (122% of Medicare)
Ins. Median: $169 (158% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $106.81 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Amish Aid $6 - $214 6%
Physicians Health Plan $6 - $307 6%
Self Pay $6 - $357 6%
Lutheran Preferred $7 - $476 7%
Cigna $8 - $288 7%
Php Freedom Network $8 - $86 7%
Aetna $9 - $355 8%
Encore Ppo $12 - $397 11%
Lutheran Network $12 - $397 11%
Medical Mutual Of Oh $13 - $421 12%
Sagamore $13 - $442 12%
Prime Health Services $18 - $596 17%
Frontpath $19 - $635 18%
Advantage Health Solutions $20 - $659 19%
Encore Health Network $20 - $715 19%
Multiplan $21 - $715 20%
Allied Benefit Systems $22 - $715 21%
Veterans Eval Services $24 - $97 22%
Blue Cross Blue Shield $54 - $455 51%
Caresource $54 51%
Humana $54 - $109 51%
Managed Health Services $54 - $221 51%
Medicaid / KanCare $54 51%
UnitedHealthcare $54 - $384 51%
Tricare $105 98%
Medicare (plans) $109 102%
Node Mhs Mcr Adv $109 102%
Department Of Veterans Affairs $111 104%
Iu Health $111 104%
Node Devoted Health Mcr Adv $111 104%
Node Non Par Hospice Agree $111 104%
Node Va $111 104%
In Dept Of Correction $115 108%
Node Pphp Mcr Adv $116 109%
Us Department Of Labor $138 129%
Lutheran Advanced Network $166 155%
Lutheran Preferred Fixed 2 $166 155%
Align In Work Comp $177 166%
Encore Work Comp In $199 186%
In Work Comp $221 207%
Encore Kba Epo $265 248%
Encore Kba Ppo $332 311%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2520 E Dupont Rd, Fort Wayne, IN 46825
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals